BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Barthel Index (Formerly the Maryland Disability Index) Year: 1958 (in use since 1955); modified in 1986 and 1987 and 1989 Domain: Biological Assessment Tool Category: Physical function Variations/Translations: The most widely used modified versions include: a 12-item version (Granger et al., 1989), a 16-item version (Nosek et.al., 1987), and a 17-item version (McGinnis et. al., 1986). McDowell and Newell (1996) recommend the use of Collin’s 10-item version or Granger et al.’s modified 15-item version (also known as the Modified Barthel Index) over the other lesser used versions. The 10 items form of the Barthel Index has been translated into Japanese (Chino et. al., 1988). Setting: Clinical Method of Delivery: Completed by a health professional or self-administered Description: The Barthel Index examines functional independence in personal care and mobility. It is used for pre and post treatment performance monitoring in long-term hospital patients with chronic paralytic conditions, and to assess the nursing care required. It has also been used with rehabilitation patients. The patient is rated from his or her medical records or from direct observation. The original Barthel Index (Mahoney & Barthel, 1958) was comprised of 10 items covering personal care and mobility. The patient is rated in terms of whether he or she can perform the tasks independently, with assistance, or is dependent on assistance. The revised Collin & Wade version of the Barthel Index reorders the items and modifies the scoring. As well, it also focuses on whether the patient actually performs the tasks rather than if he or she is capable of performance. Scoring/Interpretation: The overall scores suggest the amount of time and assistance a patient requires and is calculated from the summation of scores on each rating. Scoring on the most recent modified version ranges from 0 to 20. Higher scores indicate greater independence. Time to Administer: 2-5 minutes (by health professional), 10 minutes (self-administered) (McDowell & Newell, 1996) Availability: Found in Collin, Wade, Davies, et. al. (1988). Software: None Website: None Quantitative/Qualitative: Quantitative Validity (Quantitative): Cronbach alpha’s for internal consistency of 0.87 (at admission) to 0.92 (at discharge) has been reported. An interrater correlation of 0.99 has also been reported. The correlation between ratings and patient self-report was 0.88 (McDowell & Newell, 1996). Reliability (Quantitative): ): The number scores yielded an inter-item correlation ranging from 0.35 to 0.71 (m=0.54). The Cronbach’s alpha for internal reliability was 0.97 (McDowell & Newell, 1996). References: Chino, N., Andreson,T.P., & Granger, C.V. (1988). Stroke rehabilitation outcome studies: comparison of a Japanese facility with 17 U.S. facilities. International Disability Studies, 10, 150-154. Collin, C., Wade, D.T., Davies, S., et.al. (1988). The Barthel ADL Index: a reliability study. International Disability Studies, 10, 61-63. Granger, C.V. (1985). Outcome of comprehensive medical rehabilitation: an analysis based upon the impairment, disability, and handicap model. International Rehabilitation Medicine.,7, 45-50. Mahoney F.I., Wood, O.H., & Barthel, D.W. (1958). Rehabilitation of chronically ill patients: the influence of complications on the final goal. Southern Medical Journal. 51, 605-609. McDowell, I. & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires. (2nd ed.). New York: Oxford University Press. Pp. 56-63. McGinnis,G.E., Seward, M.L., DeJong, G., et. al. (1986). Program evaluation of physical medicine and rehabilitation departments using self-report Barthel. Archives of Physical Medical Rehabilitation, 14, 61-65. Nosek, M.A., Parker, R.M, Larsen, S. (1987). Psychosocial independence and functional abilities: their relationship in adults with severe musculoskeletal impairments. Archives of Physical Medical Rehabilitation, 68, 840-845. Wylie, C.M., & White, B.K. (1964). A measure of disability. Archives of Environmental Health, 8, 834-839. Comments: None.